2016 MANLY/ODAWARA STUDENT EXCHANGE 6 JULY TO 18 JULY 2016 APPLICATION FORM

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1 Glue (do not staple) a recent passport size COLOUR PHOTO 2016 MANLY/ODAWARA STUDENT EXCHANGE 6 JULY TO 18 JULY 2016 SELECTION CRITERIA: APPLICATION FORM To be eligible to participate in the Manly/Odawara Student Exchange please indicate with a tick in the boxes provided below whether you comply: 14 years or older as at the date of this application studying Japanese Language at High School holding a current Australian passport; or eligibility to Australian citizenship and an Australian passport residential qualifications, i.e. your parents or guardians are residents or ratepayers of the Manly Council Local Government Area or enrolled at a Campus of the Northern Beaches Secondary Colleges: Mackellar Girls, Balgowlah Boys, Cromer, Freshwater, Manly Selective or St. Paul s College or Stella Maris College Manly. Application forms are to be submitted to Manly Council by Wednesday 30 March 2016 and will then be assessed by a Selection Panel. Students will be advised if they have been selected for an interview, to be held on Sunday 10 April An Interview Panel will select students to participate in the Exchange Program. The Panel s decision is final. Student Details: (Please print clearly with black pen) School: Year: (as shown on passport) Age: Date of birth: Address: Telephone: Home: Mobile: 1

2 Mother/Guardian details: Address: Telephone: Home: Mobile: Father/Guardian details: Address: Telephone: Home: Mobile: Please list below every person living in your home: Relationship Sex (M/F) Age 2

3 SCHOOL INFORMATION NAME OF SCHOOL: YEAR: 1. Please provide details of your Japanese studies: 2. Please provide details of your interests and hobbies both in and out of school: 3. Do you belong to any community or sporting club? 4. Do you work part time? 5. Has your family previously hosted overseas students? 6. Have you ever visited Japan? Please provide details: Applicant s signature: 3

4 PARENT/GUARDIAN STATEMENT I/we are prepared to contribute approximately $2,200.00, which covers return airfares, airport transfers, group travel insurance, uniform top, accommodation (home-stay), food, activities and sightseeing in Japan, and some inclusions on the Manly Itinerary (during the Odawara student group reciprocal visit). If my/our child is selected I/we are able/unable to host in my/our home one or two students from Odawara when the reciprocal visit takes place from I/we understand hosting involves the provision of accommodation, meals, duty of care, friendship and family activities. I/we agree to abide by the rules and regulations of the Student Exchange Program. I/we are/are not prepared to host a male/female student (cross out if applicable). I/we understand that my/our child may be placed with a host family with either a boy or girl. It may be that the number of males and females participating from Manly in 2016 does not match the number of males and females travelling from Japan. I/we understand and agree that my/our child may be placed with a family in Japan who do not have a child participating in the Exchange Program. This is due to the cultural difference with Japanese homes. Some Japanese families participating in the program have very small homes and are not able to accommodate an extra person. The families selected to host Manly students are members of the Tokimeki International School Committee. In view of changes in law made to the Child Protection Act I/we know of no reason why a member of my/our household would be excluded from providing accommodation for Japanese students in my/our home. I/we understand that my/our son s/daughter s participation in the Student Exchange Program may be terminated at the discretion of the Manly Sister Cities Committee Chaperones and the Tokimeki International School Committee and that a student may be sent home from Japan at his/her expense if he/she does not adhere to the adopted rules, standards and instructions. I/we agree to ensure my/our child fully understands and respects the Japanese culture and that my/our child understands that it is not acceptable to spend an unnecessary amount of time on social media and under no circumstances will request to use the host families internet access. Name and signature of parent(s) or guardian(s): (please print) (please print) Name and signature of School Principal: (please print) 4

5 PLEASE COMPLETE INFORMATION ABOUT YOURSELF 1. Create a Welcome to Sydney card that highlights some of the activities or features of Sydney that you would like to introduce to your Odawara student. You may create this on a computer or using any other art medium. It should be no bigger than A4 size. Please submit your card with your application. 2. Would you consider yourself a leader or a good team player? Give evidence to support your answer. 3. What qualities would you have to offer as an ambassador of Manly? 4. What do you consider your responsibilities to be regarding etiquette, customs and behaviour if you are chosen as part of the group to visit Odawara City in Japan? 5. Every student is expected to participate in the farewell party concert in Odawara and in Manly. Would you be prepared to help with a musical performance, skit, comedy performance etc.? Please elaborate 5

6 SCHOOL RECOMMENDATION CONFIDENTIAL To be completed by Japanese Language Teacher (Please print clearly) Name of School: Name of Applicant: Name of sponsoring teacher/ Japanese teacher: The sponsoring teacher must be prepared to supervise a minimum of one hour of Manly Odawara Exchange activities per student accepted eg. supervising at orientation meetings, helping out at activities held during the exchange visit etc. Please provide a ranking for the student based on the number of students applying for the exchange from your school eg 3/7. School Ranking: Teacher Comment Section: What do you feel this particular student would gain from participation in the exchange program? How has this student demonstrated a positive attitude towards the study of Japanese language and a sensitivity of Japanese culture? Please provide known examples. Does this student demonstrate the ability to be part of a group and mix with different people? NOTE: This is confidential information. It will be treated in strict confidence and be used as one element in the selection process. 6